History Taking of Pain

Nyimas Fatimah
 7 Secret of Pain
1. Where
2. When
3. How
4. Frequency
5. Aggravating factor
6. Alleviating factor
7. Trying efforts and its result
 Where
• Location site of pain
• Is there any referred pain?
• Referral or radicular?
• The pattern?
 Referral pattern
(musculoskletal disorder)
 Referral pattern
(musculoskletal disorder)
Nerve System
Nerve System
Radicular Pattern (Neurogenic)
LBP with Radicular Pattern
Radicular Pattern (Neurogenic)
LBP with Radicular Pattern
Radicular Pattern (Neurogenic)
CRS
 Joint pain
is not always arhtricular origin..!!!
 When
• Acute?
• Chronic?
Acute disorder
 Acute disorder
• Acute injury of muscle and tendon: cramp,
spasm, tendon strain, muscle strain
• Acute injury of joint and adjaecent structure:
joint fracture, ligament sprain or tear,
meniscus tear, bursitis
• Overexertional problem
 Chronic disorder
• Peripheral and central nerve pain
• Degenerative
• Arthritis
• Imbalance posture
• Occupational related repetitive micro injury
• Fibromyalgia
 How
• Quantity  Intensity
• Quality  Character of pain
Quantity
Quality
Frequency
 Aggravating Factor
• Based on underlying patophysiology in
anatomy and biomechanical perspective
HNP
HNP
CTS
Weight Bearing Joint Arhtritis
 Alleviating factor
• Analgesics?
• Rest?
 Trying efforts and its result
• Massage?
• Iced or hot pack?
• Other herbal, traditional, or complementary
treatment